Stem Cells And Applications In Regenerative Dentistry
Mustafa Bekerecioğlu, Fatma Bilgen Bekerecioğlu
Dişhekimliği Dergisi
Yıl: 2024 | Cilt: 35 | Sayı: 149 | Sayfa: 22-29

Özet

Rejeneratif diş hekimliği kök hücre, biyoaktif moleküller ve iskelelerin birleşiminden oluşan ve hızla gelişen rejeneratif tıbbın bir dalıdır. Kök hücreler; kendilerini yenileyebilme, başka hücrelere dönüşebilme, sınırsız çoğalabilme ve hasarlı dokuyu onarabilme özellikleri bulunan, vücudumuzdaki bütün doku ve organları oluşturan hücreler olarak tanımlanabilir.

Klinikte en çok çalışılan erişkin kök hücre türleri hematopoetik ve mezenkimal kök hücrelerdir. Mezenkimal kök hücreler (MSC), bağ dokunun ana hücreleridir ve tüm dokularda destek hücreleri olan stromal hücrelerinde kökenini oluşturmaktadırlar. Diş kaynaklı kök hücreler rejeneratif tıp alanında yapılan çalışmalarda önemli kullanım alanına sahiptir. Diş hekimliğinde kök hücreler, alveolar kemik, dentin-pulpa kompleksi, periodonsium ve ağız boşluğu ile ilişkili diğer yumuşak dokuların rejenerasyonunu sağlamak için kullanılmaya başlanmış ve çalışmalar hız kazanmıştır.

Rejeneratif diş hekimliğinde mevcut araştırmalar, doku rejenerasyonuna aracılık edecek biyomateryaller, biyoaktif maleküller ve MSC kombinasyonu ile ilerlemektedir.

Anahtar Kelimeler

Kök Hücre, Rejeneratif Tıp, Doku Mühendisliği, Biyomalzemeler

Abstract

Regenerative dentistry is a rapidly developing branch of regenerative medicine that combines stem cells, bioactive molecules and scaffolds. Stem cells can be defined as the cells that make up all the tissues and organs in our body, which have the ability to renew themselves, transform into other cells, multiply indefinitely and repair damaged tissue.

The most widely studied adult stem cell types in the clinic are haematopoietic and mesenchymal stem cells. Mesenchymal stem cells (MSCs) are the major cells of connective tissue and give rise to stromal cells, the supporting cells in all tissues. Tooth-derived stem cells have an important application in regenerative medicine. In dentistry, stem cells have been used to regenerate alveolar bone, the dentin-pulp complex, the periodontium and other soft tissues associated with the oral cavity.

Current research in regenerative dentistry is advancing the combination of biomaterials, bioactive molecules and MSCs to mediate tissue regeneration.

Keywords

Stem Cells, Regenerative Medicine, Tissue Engineering, Biomaterials

Referanslar | References

  1. Granz CL, Gorji A, Granz CL, et al. Dental stem cells: The role of biomaterials and scaffolds in developing novel therapeutic strategies. World J Stem Cells 2020;12:897–922.
  2. Tollemar V, Collier ZJ, Mohammed MK, et al. ScienceDirect stem cells, growth factors and scaffolds in craniofacial regenerative medicine. Genes Dis 2016;3:56–71.
  3. Thalakiriyawa DS, Dissanayaka WL. Advances in Regenerative Dentistry Approaches: An Update. Internayional Dental Journal. 2024;74:25-34.
  4. Fortier LA. Stem cells: classifications, controversies, and clinical applications. Vet Surg 2005;34:415- 23.
  5. Kök Hücre Biyolojisi ve Klinik Uygulamalar. 1, Ankara: Türkiye Bilimler Akademisi; 2009.
  6. Topsakal KG, Korkmaz YN. Diş hekimliğinde kullanılan kök hücre tipleri: Literatür derlemesi Selcuk Dent J, 2019; 6: 73-81
  7. Tekeli S, Naghavi EA, Gökçe B, Sır G, Yiğittürk G, Çavuşoğlu T, Uyanikgil Y. Kök hücreler; mezenkimal kök hücreler ve güncel klinik uygulamaları. FNG & Bilim Tıp Transplantasyon Dergisi 2016;1(2):72-83.
  8. Ökçesiz A, Bucurgut ÜÜ. Sitotoksisite çalışmalarında kök hücre. Ankara Ecz. Fak. Derg. 2017;41(2): 1-14.
  9. Ural, A.U. Hematopoetik Kök Hücre. Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006; 2(43), 5-10.
  10. Müller-Sieburg CE, Cho RH, Thoman M, Adkins B, Sieburg HB. Deterministic regulation of hematopoietic stem cell self-renewal and differentiation. Blood 2002;100:1302-9.
  11. Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, et al. Multilineage potential of adult human mesenchymal stem cells. Science. 1999;284:143-7.
  12. Kern S, Eichler H, Stoeve J, Klüter H, Bieback K. Comparative analysis of mesenchymal stem cells from bone marrow, umbilical cord blood, or adipose tissue. Stem Cells 2006;24:1294-301.
  13. Hu L, Hu J, Zhao J, Liu J, Ouyang W, Yang C, et al. Side-by-side comparison of the biological characteristics of human umbilical cord and adipose tissue-derived mesenchymal stem cells. Biomed Res Int 2013;2013:438243.
  14. Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy 2006;8:315-7.
  15. Rebelatto CK, Aguiar AM, Moretao MP, Senegaglia AC, Hansen P, Barchiki F, et al. Dissimilar differentiation of mesenchymal stem cells from bone marrow, umbilical cord blood, and adipose tissue. Exp Biol Med (Maywood) 2008;233:901-13.
  16. Ding DC, Shyu WC, Lin SZ. Mesenchymal Stem Cells, Cell Transplantation. 2011; 20: 5-14. 3.
  17. Chanda D, Kumar S, Ponnazhagan S. Therapeutic Potential of Adult Bone Marrow Derived Mesenchymal Stem Cells in Diseases of the Skeleton. J Cell Bioc. 2010; 111:249-57.
  18. Ben-Ami E, Berrih-Aknin S, Miller A. Mesenchymal stem cells as an immunomodulatory therapeutc strategy for autoimmune diseases, AutoimmunityRev. 2011; 10: 410-5.
  19. Ke Y,Xiang P, Zhang C, et al. Magnetic Resonance Evaluation of Transplanted Mesenchymal Stem Cells After Myocardial Infarction in Swine, Can J Cardiol. 2011; 27:818-25.
  20. Butler WT, Ritchie HH, Bronckers AL, editors. Extracellular matrix proteins of dentine. Ciba Foundation Symposium 205-Dental Enamel; 1997: Wiley Online Library.
  21. Ruch JV. Odontoblast commitment and differentiation. Biochemistry and cell biology. 1998; 76(6): 923-38.
  22. Stanislawski L, Carreau J, Pouchelet M, Chen Z, Goldberg M. In vitro culture of human dental pulp cells: some aspects of cells emerging early from the explant. Clinical oral investigations. 1997; 1(3): 131-40.
  23. Gronthos S, Mankani M, Brahim J, Robey PG, Shi S. Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo. Proceedings of the National Academy of Sciences. 2000; 97(25): 13625-30.
  24. Miura M, Gronthos S, Zhao M, Lu B, Fisher LW, Robey PG, et al. SHED: stem cells from human exfoliated deciduous teeth. Proceedings of the National Academy of Sciences. 2003; 100(10): 5807-12.
  25. Gronthos S, Mrozik K, Shi S, Bartold P. Ovine periodontal ligament stem cells: isolation, characterization, and differentiation potential. Calcified tissue international. 2006; 79(5): 310-7.
  26. Sonoyama W, Liu Y, Fang D, Yamaza T, Seo B-M, Zhang C, et al. Mesenchymal stem cell-mediated functional tooth regeneration in swine. PloS one. 2006; 1(1): e79.
  27. Seo B-M, Miura M, Sonoyama W, Coppe C, Stanyon R, Shi S. Recovery of stem cells from cryopreserved periodontal ligament. Journal of dental research. 2005; 84(10): 907-12.
  28. Shah P. Stem cells in regenerative dentistry: Current understanding and future directions. Journal of Oral Biosciences 2024;66:288–299
  29. Somuncu MN, Zamani AG, Yıldırım MS. Hücre Dışı Veziküller ve Eksozom. Genel Sağlık Bilimleri Dergisi, 2023;5(2): 245-257.
  30. Bazzan E et al.Critical Review of the Evolution of Extracellular Vesicles' Knowledge: From to Today. International journal of molecular sciences, 2012;22(12): 6417
  31. Ertekin TS et al. , "Eksozom Yüklü Sıkıştırılabilir Kemik Greftleri,"  13. Ulusal Kimya Mühendisliği Kongresi , Van, Turkey, pp.105, 2018. 
  32. J. Shi, K.Y.W. Teo, S. Zhang et al. Mesenchymal stromal cell exosomes enhance dental pulp cell functions and promote pulp-dentin regeneration. Biomaterials and Biosystems 2023;11:100078.
  33. Wang et al. Stem cells and extracellular vesicles to improve preclinical orofacial soft tissue healing. Stem Cell Research & Therapy 2023;14:203.
  34. Ludwig N, Whiteside TL, Reichert TE. Challenges in Exosome Isolation and Analysis in Health and Disease. Int. J. Mol. Sci. 2019;20:1-11. 
  35. Wei X, Yang M, Yue L, et al. Expert consensus on regenerative endodontic procedures. Int J Oral Sci 2022;14:55.
  36. Araujo PR de S, Silva LB, Neto AP dos S, et al. Pulp revasculari-  zation: a literature review. Open Dent J 2017;10:48–56.
  37. Wikström A et al. What is the best long‑term treatment modality for immature permanent teeth with pulp necrosis and apical periodontitis? European Archives of Paediatric Dentistry 2021;22:311–340 
  38. Arshad S, Tehreem F, Rehab Khan M, et al. Platelet-rich fibrin used in regenerative endodontics and dentistry: current uses, limitations, and future recommendations for application. Int J Dent 2021;2021:4514598.
  39. Nakashima M, Iohara K, Murakami M, et al. Pulp regeneration by transplantation of dental pulp stem cells in pulpitis: a pilot clinical study. Stem Cell Res Ther 2017;8:1–13.
  40. Xuan K, Li B, Guo H, et al. Deciduous autologous tooth stem cells regenerate dental pulp after implantation into injured teeth. Sci Transl Med 2018;10(455):eaaf3227.
  41. Tomokiyo A, Wada N, Maeda H, et al. Periodontal ligament stem cells: regenerative potency in periodontium. Stem Cells Dev 2019;28(15):974–85.
  42. Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J 2021;71:462–76.
  43. Sheikh Z, Hamdan N, Ikeda Y, et al. Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review. Biomater Res 2017;21:1–20.
  44. Woo HN, Cho YJ, Tarafder S, et al. The recent advances in scaffolds for integrated periodontal regeneration. Bioact Mater 2021;6:3328–42.
  45. Han J, Menicanin D, Gronthos S, et al. Stem cells, tissue engineering and periodontal regeneration. Aust Dent J 2014;59:117–30.
  46. Miron RJ, Moraschini V, Fujioka-Kobayashi M, et al. Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis. Clin Oral Investig 2021;25:2461–78.
  47. Agrawal A, Dhadse P, Kale B, et al. A blind randomized controlled pilot trial on recombinant human bone morphogenetic protein-2 in combination with a bioresorbable membrane on periodontal regeneration in mandibular molar furcation defects. Quintessence Int 2023;54:112–24.
  48. Shalini HS, Vandana KL. Direct application of autologous periodontal ligament stem cell niche in treatment of periodontal osseous defects: a randomized controlled trial. J Indian Soc Periodontol 2018;22:503–12.
  49. Cui D et al. Mesenchymal Stem Cells for Cartilage Regeneration of TMJ Osteoarthritis. Stem Cells International. 2017;  https://doi.org/10.1155/2017/5979741
  50. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician 2015;91(6):378–86.
  51. Kohnke R, Ahlers MO, Birkelbach MA, et al. Temporomandib- € ular joint osteoarthritis: regenerative treatment by a stem cell containing advanced therapy medicinal product (atmp)—an in vivo animal trial. Int J Mol Sci 2021;22:1–16.
  52. Wieckiewicz M et al. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain 2015;16:106.
  53. De Riu G et al. Bone marrow nucleated cell concentrate autograft in temporomandibular joint degenerative disorders: 1-year results of a randomized clinical trial. J Craniomaxillofac Surg 2019;47:1728–38.
  54. Zhang M, Yang H, Lu L, et al. Matrix replenishing by BMSCs is beneficial for osteoarthritic temporomandibular joint cartilage. Osteoarthr Cartil 2017;25:1551–62.
  55. Ogasawara N, Kano F, Hashimoto N, et al. Factors secreted from dental pulp stem cells show multifaceted benefits for treating experimental temporomandibular joint osteoarthritis. Osteoarthr Cartil 2020;28:831–41.
  56. Zhang S, Teo KYW, Chuah SJ, et al. MSC exosomes alleviate temporomandibular joint osteoarthritis by attenuating inflammation and restoring matrix homeostasis. Biomaterials 2019;200:35–47.
  57. Zhang S, Chuah SJ, Lai RC, et al. MSC exosomes mediate cartilage repair by enhancing proliferation, attenuating apoptosis and modulating immune reactivity. Biomaterials 2018;156:16– 27.
  58. AbuBakr N, Fares AE, Mostafa A, et al. Mesenchymal stem cells-derived microvesicles versus platelet-rich plasma in the treatment of monoiodoacetate-induced temporomandibular joint osteoarthritis in Albino rats. Heliyon 2022;8:e10857.
  59. Holly D et al. M. Stem Cells and Their Derivatives —Implications for Alveolar Bone Regeneration: A Comprehensive Review. Int. J. Mol. Sci. 2021;22:11746. https://doi.org/10.3390/ ijms222111746.
  60. Tetè G, et al. Role of induced pluripotent stem cells (IPSCS) in bone tissue regeneration in dentistry: A narrative review. J. Biol. Regul. Homeost. Agents 2021;34: 1–10.
  61. Paz A.G, Maghaireh H, Mangano F.G. Stem Cells in Dentistry: Types of Intra- and Extraoral Tissue-Derived Stem Cells and Clinical Applications. Stem Cells Int. 2018; 2018:1–14.
  62. Fernandez De Grado G et l.Bone substitutes: A review of their characteristics, clinical use, and perspectives for large bone defects management. J. Tissue Eng. 2018;9: 2041731418776819.
  63. Funda G et al. Nanotechnology Scaffolds for Alveolar Bone Regeneration. Materials 2020;13: 201.
  64. Rodriguez AM et al. The human adipose tissue is a source of multipotent stem cells. Biochimie 2005, 87, 125–128.
  65. Lei M et al. Mesenchymal stem cell characteristics of dental pulp and periodontal ligament stem cells after in vivo transplantation. Biomaterials 2014;35; 6332–6343.
  66. Gan L et al. Dental Tissue—Derived Human Mesenchymal Stem Cells and Their Potential in Therapeutic Application. Stem Cells Int. 2020; 8864572.
  67. Liu W et al. Hypoxic mesenchymal stem cell-derived exosomes promote bone fracture healing by the transfer of miR-126. Acta Biomater. 2020;103:196–212.
  68. Zhang Y et al. Umbilical Mesenchymal Stem Cell-Derived Exosome-Encapsulated Hydrogels Accelerate Bone Repair by Enhancing Angiogenesis. ACS Appl. Mater. Interfaces 2021;13:18472–18487.